Decoding gut microbiome alterations in celiac disease: Implications for pathogenesis and treatment

Area of Science:

• Gastroenterology and Immunology
• Microbiome Research

Background:

• Celiac disease (CD) is an immune disorder caused by gluten in genetically susceptible individuals.
• A strict gluten-free diet (GFD) is the primary treatment but often fails to fully resolve symptoms or restore gut microbiome balance.
• Microbial dysbiosis is implicated in CD pathogenesis, progression, and persistent symptoms.

Purpose of the Study:

• To review the complex interactions between the gut microbiome and celiac disease.
• To explore the role of microbial dysbiosis in CD initiation, heterogeneity, and symptom persistence.
• To discuss emerging microbiome-modulating therapies as adjunctive treatments for CD.

Main Methods:

• Literature review summarizing current evidence on microbiome-CD interactions.
• Analysis of studies on microbial gluten metabolism and GFD effects.
• Discussion of potential therapeutic strategies targeting the gut microbiome.

Main Results:

• Gut microbiome alterations are observed in individuals at risk, with active CD, and on GFD.
• Microbial dysbiosis plays a role in gluten metabolism, immune response, and barrier function in CD.
• GFD alone may not fully normalize the gut microbiome in CD patients.

Conclusions:

• The gut microbiome is a critical factor in celiac disease pathogenesis and treatment response.
• Modulating the gut microbiome offers potential as an adjunctive therapy for CD.
• Personalized microbiome-based strategies could improve long-term outcomes for CD patients.